Obstacles to Female Condom Distribution Outlined in New Report

A new report commissioned by the Center for Health and Gender Equity (CHANGE) blames “bureaucratic obstacles, funding restrictions, and a lack of high level commitment to female condoms” for delaying the expansion of U.S.-funded female condom distribution efforts.

But the biggest deterrent — for both male and female condoms — lies within U.S. global policy concerning HIV prevention.

The report, “Saving Lives Now: Female Condoms and the Role of U.S. Foreign Aid,” takes to task the U.S. Office of the Global AIDS Coordinator, which prioritizes condom promotion programs under the President’s Emergency Plan for AIDS Relief (PEPFAR) only for “high-risk persons.”

Also damaging is the congressionally mandated requirement that PEPFAR spend 33 percent of all HIV prevention funds on abstinence-until-marriage programs, which funnel money toward programs that only promote abstinence and fidelity as means of preventing HIV.

“Saving Lives Now” is available for free at PreventionNow.net (download PDF), a global campaign to expand access to female condoms. CHANGE and its U.S. partners work with existing female condom campaigns in other countries such as Argentina, Ghana, and Zambia.

Female condoms account for just 0.2 percent of total global condom supply. The report found that female condoms are available in 108 countries, but they are not readily accessible in most countries. The United States has supplied female condoms to 30 countries in the past decade and to 16 countries in 2007. Nearly 26 million female condoms were distributed worldwide in 2007, compared to 11 billion male condoms.

“It is distressing that women make up half of those infected by HIV and policy makers are refusing to provide women with the tools they need to negotiate safer sex,” said Serra Sippel, CHANGE executive director. “The U.S. and other donors must increase comprehensive funding for the purchase, distribution and programming of female condoms to ensure that women and men have access to female condoms and know how to use them.”

Based on interviews with health experts and a review of current literature on female condoms, the report’s executive summary (PDF) offers the following findings and common-sense recommendations:

FINDING: U.S. agencies responsible for female condom programming and procurement do not have polices that promote the integration of female condoms into HIV prevention and family planning programs. Whether the U.S. procures female condoms in a given country is highly dependent on the personal biases of USAID mission staff.

RECOMMENDATION: USAID and OGAC should issue policy guidance promoting female condom procurement and programming within U.S.-funded development programs, including PEPFAR. As a signatory of ICPD, the U.S. should promote female condoms as a vital tool to prevent both pregnancy and HIV infection.

FINDING: The U.S. excels at assisting countries in female condom logistics and procurement.

RECOMMENDATION: The U.S. should expand technical assistance for female condom logistics and procurement to additional countries to increase HIV prevention efforts.

FINDING: Sustained product availability and effective programming is limited to a few countries. Accurate estimates for female condom needs do not exist.

RECOMMENDATION: The U.S. should apply intensive programming efforts to an additional three countries for scale-up and replication. These efforts could be used to create a more realistic assessment of global female condom needs for scale-up.

Plus: Here’s a post from last year on efforts to redesign the female condom and problems with raising money in the United States for the clinical trials required for FDA approval.